PDF(Pubmed)
Abstract：
Since the first successful repair of esophageal atresia/tracheoesophageal fistula (EA-TEF) was performed approximately 8 decades ago, surgeons have made considerable technical advances in solving intraoperative surgical challenges and reducing postoperative complications. According to some surgeons, preserving the Azygos vein makes this modification attractive. This study aimed to evaluate the benefits of preserving the Azygos vein during surgery for esophageal atresia with tracheoesophageal fistula and to highlight its advantages in reducing anastomotic leak, stricture, and other postoperative outcomes. This prospective comparative series was conducted between April 2020 and April 2023. The study included all newborns with EA-TEF eligible for primary repair. Patients were randomized to either Group A or B. Group A underwent Azygos vein preservation, whereas the remaining patients (Group B) underwent Azygos vein disconnection. Sixty-four patients were included in this study. Thirty-two patients (Group A) underwent Azygos vein preservation during EA-TEF repair, and the remaining thirty-two patients (Group B) underwent Azygos vein ligation and disconnection. Both groups were comparable in terms of demographics, clinical data, and operative findings (P > 0.05). Pneumonitis occurred in 4 patients in Group A and 16 patients in Group B. Anastomotic leaks occurred in two (6.2%) patients in Group A and six (18.7%) patients in Group B. There were two deaths in Group A and six deaths in Group B, with a significant difference between the two groups (P = 0.0485). Preserving the Azygos vein during esophageal atresia repair reduces the occurrence of postoperative pneumonia, leakage, and stenosis, and decreases postoperative mortality. Therefore, we declare that this modification is a significant and valuable addition to the current surgical procedures.
摘要：
自从大约80年前首次成功修复食管闭锁/气管食管瘘（EA-TEF）以来，外科医生在解决术中手术挑战和减少术后并发症方面取得了相当大的技术进步。根据一些外科医生的说法，保留Azygos静脉使这种修饰具有吸引力。本研究旨在评估在食管闭锁伴气管食管瘘手术中保留Azygos静脉的益处，并强调其在减少吻合口漏方面的优势。狭窄,和其他术后结果。这个前瞻性比较系列是在2020年4月至2023年4月之间进行的。该研究包括所有有资格接受初次修复的EA-TEF新生儿。患者被随机分为A组或B组。而其余患者（B组）接受了Azygos静脉断流术。本研究包括64名患者。32例患者（A组）在EA-TEF修复期间接受了Azygos静脉保存，其余32例患者（B组）接受了Azygos静脉结扎和断开。两组在人口统计学方面具有可比性，临床资料,和手术结果(P>0.05)。A组4例发生肺炎,B组16例发生吻合口瘘,A组2例(6.2%)发生吻合口瘘,B组6例(18.7%)发生吻合口瘘,A组2例死亡,B组6例死亡,两组间差异有统计学意义(P=0.0485)。在食管闭锁修补术期间保留Azygos静脉可减少术后肺炎的发生，泄漏,狭窄，并降低术后死亡率。因此,我们声明这一修改是对当前外科手术的重要和有价值的补充.
